A 32 year old patient complains about heartburn and dull pain in the epigastrium that appear 2-3 hours after meal. Exacerbations happen in spring and in autumn. The patient has food intolerance of eggs and fish. Objectively: stomach palpation reveals painfulness in the gastroduodenal area. Electrophasoduodenoscopy revealed a 5 mm ulcer on the anterior wall of duodenum. Urease test is positive. What is the most probable leading mechanism of disease development?

Correct Answer: A

Rationale: The correct answer is A: Helicobacterial infection. This is the most probable leading mechanism of disease development in this case because the patient's symptoms, such as heartburn, epigastric pain, food intolerance, and presence of a duodenal ulcer with a positive urease test, are classic signs of Helicobacter pylori infection. This bacterium colonizes the stomach lining, leading to inflammation and ulcer formation. The exacerbations in spring and autumn could be due to seasonal variations in immune response. Choice B: Dietary allergy is incorrect because the symptoms and findings in the patient are more indicative of an infectious etiology rather than an allergic reaction to specific foods. Choice C: Autoantibody production is unlikely as there are no indications of an autoimmune process in this case. Choice D: Reduced prostaglandin synthesis is not the leading mechanism as the symptoms and findings are more consistent with an infectious cause rather than a deficiency in prostaglandin synthesis.

Correct Answer: C

Rationale: The correct answer is C: Plague. Yersinia pestis is the bacterium responsible for causing the bubonic, septicemic, and pneumonic plague. The bacterium is transmitted to humans through infected flea bites or handling infected animals. Tonsillitis (A) is commonly caused by streptococcal bacteria, leprosy (B) is caused by Mycobacterium leprae, and rat fever (D) is another term for leptospirosis, caused by Leptospira bacteria.

Correct Answer: D

Rationale: The correct answer is D because fires from flammable metals require specialized Class D fire extinguishers designed to extinguish these unique types of fires. Class A, B, and C fire extinguishers are not suitable for flammable metal fires as they are designed for different types of materials and fire classes. Class A extinguishers are for ordinary combustibles, Class B for flammable liquids, and Class C for electrical fires. Therefore, Class D fire extinguishers are specifically designed for flammable metal fires, making them the correct choice for this scenario.

Correct Answer: C

Rationale: The correct answer is C because isolating a defined microorganism in pure culture involves obtaining a single, distinct colony on solid media. This ensures that only one type of microorganism is present in the culture, preventing contamination. Liquid media can harbor multiple organisms, making it challenging to isolate a specific microorganism. Therefore, choice A is incorrect. Choice B is also incorrect as liquid nutrient media does not provide the necessary isolation required for pure culture. Choice D is incorrect because isolating from single colonies on solid media allows for the pure culture of the defined microorganism.

Correct Answer: B

Rationale: The correct answer is B: Helicobacter pylori. This bacterium is associated with stomach ulcers as it can survive in the acidic environment of the stomach and produce substances that weaken the stomach lining. Escherichia coli (A) is associated with foodborne illnesses, not ulcers. Bacillus cereus (C) causes food poisoning. Clostridium difficile (D) is associated with antibiotic-associated colitis, not ulcers. Therefore, Helicobacter pylori is the correct answer based on its specific association with stomach ulcers.

Correct Answer: A

Rationale: Rationale: Metronidazole is the drug of choice for treating lambliosis due to its effectiveness against Giardia lamblia, the parasite causing the infection. Metronidazole works by disrupting the DNA structure of the parasite, leading to its death. Erythromycin (choice B) is not effective against Giardia lamblia. Monomycin (choice C) and Chingamin (choice D) are not commonly used for treating lambliosis. Therefore, choice A, Metronidazole, is the correct medication for this patient.

Correct Answer: A

Rationale: The correct answer is A: Capsule. A capsule is a mucous structure tightly bound to the bacterial cell wall with distinct outer boundaries. This structure helps bacteria evade the host immune system, resist desiccation, and adhere to surfaces. In contrast, spores are resistant structures formed by certain bacteria for survival, filaments are long chains of bacterial cells, and ribosomes are cellular organelles responsible for protein synthesis. Therefore, based on the characteristics described in the question, the most appropriate choice is A: Capsule.

Correct Answer: A

Rationale: The correct answer is A: Staphylococcus aureus. Staphylococcus aureus is a Gram-positive cocci bacterium that forms clusters and commonly causes pneumonia with a productive cough and fever. It is frequently found in sputum smears in such cases. Streptococcus pneumoniae (B) is another common cause of pneumonia but typically appears in pairs or chains, not clusters. Neisseria meningitidis (C) is a Gram-negative diplococcus that causes meningitis, not pneumonia. Klebsiella pneumoniae (D) is a Gram-negative bacterium that can cause pneumonia but appears as Gram-negative rods, not Gram-positive cocci in clusters.

Correct Answer: B

Rationale: The correct answer is B: Catalase. Catalase is the enzyme responsible for breaking down hydrogen peroxide into water and oxygen. This process helps protect the bacteria from oxidative damage caused by hydrogen peroxide. Amylase (A), Lipase (C), and Protease (D) are enzymes that are not involved in breaking down hydrogen peroxide. Amylase is involved in breaking down starch, Lipase breaks down lipids, and Protease breaks down proteins. Therefore, they are not the correct enzymes for the given question.